Post-Cyst Removal: Scars and Potential Recurrence

Post-operative care for sebaceous cysts?

Hello, I recently had a sebaceous cyst excised by a dermatologist.
The wound has been sutured and healed, but there are still dark spots beneath the scar (similar to the color of the cyst before it was removed), and they are not raised.
Could this indicate that the cyst was not completely excised or that it has recurred? Should I seek further medical treatment? Thank you.

E, 20~29 year old female. Ask Date: 2023/10/16

Dr. Wu Yuxin reply Dermatology

I apologize, but without actually seeing the lesion, I cannot make an accurate assessment.
I recommend that you have the surgeon evaluate it again.

Reply Date: 2023/10/16

More Info

After undergoing cyst removal, it's understandable to have concerns about the healing process, scarring, and the potential for recurrence. Based on your description, it seems that you have a scar with a dark spot underneath, which resembles the appearance of the cyst prior to removal. This situation can be concerning, and it's important to address your questions with a comprehensive understanding of the healing process and the nature of cysts.

Firstly, it is essential to recognize that the healing process after cyst removal can vary significantly from person to person. Scars can take time to mature, and during this period, they may change in color, texture, and appearance. The dark spot you are observing could be a result of several factors, including pigmentation changes in the skin, remnants of the cyst wall, or even a new cyst formation.
Cysts, particularly sebaceous cysts (which are often referred to as epidermoid cysts), can sometimes have a tendency to recur if the entire cyst sac is not completely excised. If any part of the cyst wall remains, it can potentially lead to the formation of a new cyst. However, it is also possible that the dark spot is simply a benign pigmentation change resulting from the surgical procedure or the healing process.

To determine whether the dark spot is indicative of a recurrence or simply a normal part of healing, consider the following steps:
1. Observation: Monitor the area for any changes over time. If the dark spot remains stable, it may not be a cause for concern. However, if you notice any growth, changes in color, or if it becomes painful, it would warrant further evaluation.

2. Consultation with a Dermatologist: It is advisable to follow up with your dermatologist or the surgeon who performed the cyst removal. They can assess the area more thoroughly, possibly using imaging techniques or a physical examination to determine if there is any cyst material present or if the dark spot is simply a post-surgical change.

3. Biopsy: In some cases, if there is uncertainty about the nature of the dark spot, a dermatologist may recommend a biopsy to rule out any other conditions, including the possibility of a recurrence.

4. Scar Management: Regardless of whether the dark spot is a recurrence or a normal part of healing, you may want to discuss scar management options with your healthcare provider. Treatments such as silicone gel sheets, topical treatments, or laser therapy can help improve the appearance of scars.

5. Patience: Remember that scars can take several months to fully mature, and their appearance can change significantly during this time. It is not uncommon for scars to initially appear darker or more pronounced before they fade.

In summary, while the presence of a dark spot beneath your scar could raise concerns about recurrence, it is essential to consult with a healthcare professional to get a definitive diagnosis. They can provide personalized advice based on a thorough examination and your medical history. Early intervention can help address any issues and provide peace of mind regarding your recovery.

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